Purpose
The aim of the study was to investigate visual outcome in patients with traumatic cataract after cataract surgery and to study the various etiological factors.
Patients and methods
A prospective study was carried out on all patients with traumatic cataract who underwent cataract extraction with primary intraocular lens implantation at a tertiary eye hospital between January 2012 and December 2014. Data were collected on age, sex, preoperative vision, postoperative vision at 3–6 months, and postoperative complications responsible for decreased visual acuity.
Results
Fifty eyes in 50 patients were studied. The study population comprised 36 male and 14 female patients. The preoperative visual acuity was less than 6/60 in all 50 eyes. The postoperative visual acuity in 28 eyes was 6/6–6/12, whereas 20 eyes had visual acuity of 6/18–6/36 and two eyes had visual acuity less than 6/60. The cause of poor visual acuity was mainly corneal opacity and posterior capsular opacity.
Conclusion
Our study shows that good visual results can be achieved with traumatic cataract surgery if the posterior segment is not involved and the corneal scar does not block the optical axis.

Purpose
The aim of this study was to compare electron microscopic morphological images of the posterior surface of corneal lenticules removed during femtosecond laser small-incision lenticule extraction (SMILE) with free corneal caps created using a mechanical microkeratome.
Design
An in-vitro comparative study was carried out including 30 human corneal lenticules from 15 patients who underwent bilateral SMILE refractive procedure (SMILE group) using the 500 kHz VisuMax femtosecond laser and 20 cadaveric donor corneas that were cut creating free caps using the Moria M2 microkeratome.
Setting
The present study was carried out at Roayah Vision Correction Center and Faculty of Science, Alexandria University.
Participants and methods
A total of 15 SMILE lenticules and 15 microkeratome free caps were examined by scanning electron microscopy (SEM), and another 15 SMILE lenticules and five microkeratome free caps were examined by transmission electron microscopy. The JEOL JSM-5300LV SEM was used for observations. A new scoring system was used for comparison.
Results
The surface and edge of SMILE lenticules showed more roughness in the form of tissue bridges, dome-shaped elevations, more cavitational changes, and tiny tissue fragments compared with the undersurface of free corneal microkeratome caps, but the difference was not statistically significant on SEM (P=0.40654).
Conclusion
SMILE induces corneal surface roughness and structural changes that are slightly more pronounced than those induced by the microkeratome. The observed changes may cause surgically induced optical aberrations. Energy settings still need further adjustment to be able to create reproducible, predictable smooth surfaces in lenticules of SMILE cases.

Aim
The aim of the study was to evaluate the efficacy and complications of a new expanded polytetrafluoroethylene (Gore-Tex) suture in frontalis suspension in severe congenital upper-eyelid blepharoptosis with poor levator function (4 mm or less) wherein fascia lata is difficult to harvest in young children.
Patients and methods
In a retrospective study, frontalis suspension was performed in patients with severe congenital ptosis in whom the levator function was 4 mm or less. The procedure was performed in 62 eyes of 40 patients between February 2010 and March 2013. The mean follow-up duration was 12 ± 2 months. Forty patients were included in this study, 26 girls and 14 boys, with an average age of 2.8 ± 0.1 years. Frontalis suspension was performed with the open approach using a single pentagon suture (Fox procedure).
Results
The average margin reflex distance was −0.55 mm preoperatively, which improved to +2.2 mm at 6 months postoperatively (P < 0.009) and then decreased to +1.55 mm 1 year postoperatively (P = 0.005). Six eyes (10%) showed complete recurrence. Twenty-two eyes (35%) experienced partial recurrence. The average period of recurrence was 6.56 months. Postoperative complications such as suture granuloma, infection, exposure, lagophthalmus, and overcorrection occurred in a few patients.
Conclusion
The use of the new version of Gore-Tex suture as a suspensory material in frontalis suspension in severe congenital upper-eyelid blepharoptosis is safe and effective and can be recommended for clinical use.

Purpose
The aim of this study was to evaluate the pressure-lowering effect of 577 nm micropulse laser trabeculoplasty in eyes treated for primary open-angle glaucoma.
Patients and methods
This prospective interventional case series included 30 eyes of 30 patients treated for primary open-angle glaucoma (one eye of each patient).
Treatment
was delivered using the IQ 577 nm laser system with fixed treatment parameters: 577-nm (yellow) wavelength, 300-µm spot size, 300-ms envelope duration using 1000 mW of power at a 15% duty cycle, and delivering confluent applications for 360°.
Results
The mean intraocular pressure at baseline was 18.07±1.91 mmHg. There was a prompt and significant decrease in intraocular pressure that was maintained during the 6-month follow-up, reaching 14.17±1.56 mmHg (P<0.0001).
Conclusion
Five-hundred and seventy-seven nanometer micropulse laser trabeculoplasty offers a safe, effective adjuvant treatment to pharmacotherapy in treating primary open-angle glaucoma.

The effect of change of check size and wavelength of stimulus on visual-evoked potential parametersMona AbdelkaderJune 2016, 17(2):73-79DOI:10.4103/1110-9173.189469

Purpose of the study
The present study was conducted to evaluate the effect of change of wavelength of flash stimulus and change of check size on the parameters of the visual-evoked potential (VEP) amplitude and latency in normal individuals.
Participants and methods
The study included 300 eyes of 150 healthy study participants with age range of 20–45 years. They were exposed to a flash visual-evoked potential (FVEP) with white light and blue color, and to a pattern reversal visual-evoked potential with checks subtending visual angles of 15, 30, 60, and 120 min of arc. The measured data were statistically analyzed and summarized by histograms. The interindividual and intraindividual variability in latencies and amplitudes for FVEP were assessed using the coefficient of variation.
Results
There were statistically significant differences between blue and white FVEP latencies, whereas there were no statistically significant differences between white and blue FVEP amplitudes. Blue FVEP had less interindividual and intraindividual variability. There was a statistically significant difference in latencies between different check sizes.
Conclusion
Monochromatic FVEP was preferred than white, as there were minimal interindividual and intraindividual variations of latencies and amplitudes. The most preferred check size in pattern VEP was 120′.

Objective
To evaluate the macular ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) measurements with Fourier-domain optical coherence tomography (FDOCT) for the detection of early glaucoma and to compare the results with visual field (VF) defects.
Design
This was a cross-sectional prospective diagnostic study.
Patients and methods
This study included 10 normal eyes and 48 eyes of patients suspected of having glaucoma on the basis of the appearance of the optic disc. All eyes had normal VFs by standard automated perimetry before the imaging session. A FDOCT system was used to map the macula and peripapillary regions of the retina. Short-wave automated perimetry was performed. Areas under the receiver operating characteristic curves (AUC) were calculated to summarize the diagnostic accuracies of the parameters.
Results
The AUCs for the VF parameters were 0.819 for the mean deviation and 0.911 for the pattern standard deviation. AUCs for the RNFL parameters ranged from 0.625 for the superior average thickness to 0.693 for the inferior average RNFL thickness. AUCs for the macular parameters ranged from 0.467 for the GCC–global loss volume to 0.556 for the inferior GCC thickness. The AUC of the VF parameter with the largest AUC, pattern standard deviation, was significantly higher than that of the RNFL and macular parameters (0.911 vs. 0.693 and 0.556).
Conclusion
GCC measurements with FDOCT were similar to the RNFL parameters, but were inferior to VF deficits on short-wave automated perimetry for early detection of glaucoma.

Purpose
The aim of the study was to estimate the age-specific and sex-specific prevalence of age-related macular degeneration (AMD) among elderly patients attending Alexandria Main University Hospital.
Study design
A cross-sectional survey was conducted.
Patients and methods
Patients aged 55 years or older were randomly selected from those attending different outpatient clinics at Alexandria Main University Hospital. One thousand eyes of 532 patients were included in the study. They underwent full ophthalmic examination with fundus photography. The fundus photographs were graded into early and late AMD according to the International Age-Related Macular Epidemiological Study Group Classification system. Prevalence rates were calculated.
Results
The overall prevalence of AMD was 6.6%. The prevalence of early and late AMD was 5.3 and 2.4%, respectively. There was a significantly higher prevalence of early and late AMD among those aged at least 75 years as compared with other age groups. The prevalence of AMD among male participants was 9.2% compared with only 4.1% among female participants. When potential risk factors were analyzed, smokers and those suffering from hypertension were associated with a significantly higher prevalence of AMD than were nonsmokers or those without hypertension. Diabetes mellitus was not significantly associated with AMD.
Conclusion
In this study, the prevalence of early AMD in younger age groups was lower than that found in other population-based studies in western populations. The prevalence of AMD increased with age and was significantly higher among men and smokers.

Purpose
The aim of the study was to evaluate the visual outcome and central macular thickness (CMT) after intravitreal injection of bevacizumab in conjunction with macular laser photocoagulation (MLP) for the treatment of diabetic macular edema (DME).
Patients and methods
This is a prospective, interventional, case study. A total of 32 eyes were included in this study. The following data were recorded at baseline and during the follow-up periods (≤6 months): best-corrected visual acuity (BCVA), CMT, fluorescein angiography, slit-lamp biomicroscopy, and intraocular pressure measurement by applanation tonometry. All eyes received intravitreal bevacizumab at a dose of 1.25 mg in 0.05 ml 2 weeks before MLP, which was applied in a focal or grid pattern according to the treatment map.
Results
This study included 32 eyes of 27 patients, 16 of whom were men and 11 were women. The mean baseline BCVA was 0.29 ± 0.11 decimal Snellen’s equivalent, and the final mean BCVA was 0.38 ± 0.13. Analysis of the final BCVA revealed that 15 (47%) eyes improved by two or more lines of BCVA, 16 (50%) eyes remained stable, and one (3%) eye lost one line of BCVA. Mean CMT at baseline was 625.18 ± 82.88 μm, which decreased to a mean of 283.46 ± 22.47 μm at the end of the follow-up period covering 6 months.
Conclusion
Primary treatment for DME with intravitreal bevacizumab in conjunction with MLP results in improvement or stabilization of BCVA and reduces CMT. Combined therapy seems to be an effective modality for treatment of DME.

Introduction
Endophthalmitis, despite being rare, is the most serious complication of ocular surgery. Aminoglycosides, used in combination with vancomycin (VAN), were found to cause macular toxicity. Ceftazidime has been suggested as an alternative antibiotic because of its lower risk of retinal toxicity.
Purpose of the study
The purpose is to evaluate outcome of intravitreal injection (IVI) of VAN and ceftazidime combination versus ciprofloxacin on experimentally induced endophthalmitis.
Materials and methods
Twenty-one albino rabbits were divided into three groups as follows: group I received IVI of 0.1 ml saline, group II received IVI of VAN (1 mg/0.1 ml) and ceftazidime (2.25 mg/0.1 ml), and group III received IVI of ciprofloxacin (1 mg/0.1 ml). Right eyes were inoculated with 105 colony forming units (CFU)/0.l ml of Staphylococcus epidermidis. After 24 h, inoculated eyes were examined by indirect ophthalmoscopy for signs and severity of endophthalmitis according to the modified scheme of Peyman and Bassili, and IVI was provided. On day 3 of the study, inoculated eyes were re-examined clinically, vitreous samples were obtained for bacteriological examination, and if culture was positive, antibiotics were reinjected. On day 6, animals were killed, right eyes were enucleated, and contents of the posterior segment were inoculated on blood agar for evaluation of bacterial growth and counting the CFU.
Results
On day 3, frequency of animals having severe grades of conjunctival injection and corneal edema was significantly higher in groups I and III compared with group II, and not significantly higher in group I compared with group III. Frequency of animals showing good red reflex was significantly higher in group II compared with groups I and III, and not significant different in group III compared with group I. On day 3, the mean number of CFU was significantly lower in group II compared with groups I and III with significantly lower number in group III compared with group I. On day 6, all samples of group II were sterile, while mean number of CFU was significantly lower in group III compared with group III.
Conclusion
Combined therapy using VAN and ceftazidime provided proper clinical and bacteriological control of experimentally induced endophthalmitis, with significant difference from single-drug therapy.